Where did we go right? Positive aspects of residential child care

Date Posted: Tuesday, 20 April 2010

This is the text of a presentation I gave to the first Joint National Conference of IASCW, RMA and IASCE “Social Care under the Spotlight” at the Sheraton Hotel, Athlone on February 24th and 25th, 2010 For brevity’s sake and no other reason I have used the convention of referring to young people as masculine and residential child care workers as feminine except where specific individuals are referred to. In order to avoid tedious repetition children and young people are also referred to as “youngsters” and “kids”. The details about Jimmy (which is not his name) and his life have been substantially altered.

Where did we go right? Positive aspects of residential child care

As ever it has been a difficult time for residential child care in general, no more so than in Ireland. In the face of these difficulties my presentation asks you to consider those aspects of social care which even in the most difficult and troubling situations can meet the needs of troubled youngsters, their families and the wider community. I will do this by talking about residential child care in which field the vast majority of my own experience lies. Some of the propositions I will be putting forward are underpinned by past and current thinking on attachment theory, the ideas of the English paediatrician and psychoanalyst Donald Winnicott, the psychoanalyst Melanie Klein, and the theory of groups formulated by another psychoanalyst Wilfred Bion. I may not always cite them but I will be posting the full text of this presentation with the references and ideas for further reading on the www.goodenoughcaring.com website soon after I return to England. Once I have completed the scripted part of my presentation I hope that there will be time to allow me to tell you a story which should illustrate some of the points I will be making.

I originally proposed that the title of this presentation would be “Where did it all go right?” Somehow on crossing the Irish Sea it became translated to “Where did we go right”? I didn’t question the alteration since clearly things have not all gone right for residential child care in Ireland or for that matter anywhere else. This diffidence about what we achieve in our work is not surprising. We operate in a field of social care where those who use our services are encountering social, emotional, health and educational difficulties, One can therefore not reasonably ask, “Where did it all go right?” but we can justifiably ask, “Where does it go right?” Despite the naïve managerialist demands and claims of government ministries there are no ‘bolt on’ fixes in our work. To be sure I am stating today that we should acknowledge that though it may often be quite messy – after all we are human beings not automatons – for much of the time and in many of its day to day details our work is going right.

The legacy of a Masud Hoghughi Lecture

In 1985 I attended a lecture given by Masud Hoghughi who was then the head of Aycliffe School in County Durham England. During his lecture Masud said something which I have not forgotten. It was something we all know but seldom acknowledge. He observed that there is a sense in which residential child care is always effective. It provides an instant solution to one of society’s urgent problems. He suggested that each time a social worker makes a request to residential child care workers to admit a troubled – or from another point of view troublesome – youngster and we answer the request by offering the child a place to stay, we, the residential child care providers have managed a crisis for the wider community. By taking in a child we provide an immediate solution – even if only a temporary one – to what has become for others an unmanageable problem. No one would argue that this is our principal purpose, but it is significant purpose. At a time when a family situation has broken down, when a foster care placement has broken down or indeed when a residential child care placement may have broken down and there is no feasible alternative, the residential resource that takes in a child provides relief for the wider community. More importantly by accepting the child, a residential resource provides an important therapeutic service for it cannot help a youngster if he believes that nobody wants to look after him or at the other extreme if he feels so omnipotent that he experiences himself beyond the control of adults. How fearful that must be. In having the capacity to manage other people’s crises we are getting things right.

I hope I have administered a large crumb of comfort, and before I return to the other ways in which I believe residential child care workers get things right I thought I should ensure a balance and look at some of the obstacles that stand in our way as we try to do our job well.

Our resistance to looking at ourselves

Important though it is, our role is not only to provide a holding pen to contain the unmanageable crises of troubled youngsters and their home communities. Our work is longer term and, at a personal level, it is much deeper. Many of us will remember how we as new workers to this field so quickly found that this work was not as straightforward as our innocent altruism first led us to believe. Residential child care makes an immediate emotional impact upon us. Suddenly we are confronted with on the one hand a child who seems intent on making an intensely close relationship with us, while on the other, with a child who seems determined to detach himself from us. We encounter too – though we may deny it – our own resistance to making relationships. We begin to question our own capacity to attach to others who initially may make us feel uncomfortable. However difficult this is for us to acknowledge we become aware of our own resistance to “getting it right” as both individual carers and as members of a team. As long as we are able to bear these anxieties in mind they should not overly alarm us. It is when they are – over the passage of time – consistently denied that problems arise.

Those who like me are influenced by psychodynamic explanations of human behaviour have used the myth of King Oedipus to explain the resistance we have to reflecting too deeply upon our own actions. The myth contains some general psychological indicators, which can illuminate the societal group behaviour of human beings. As you may know Oedipus sets out to discover and punish whoever was responsible for the dreadful crimes of matricide and incest. A final and awful revelation comes when he realises that these evil acts were carried out by himself and not by other people. This capacity to deny the bad parts of ourselves because acceptance of them at a conscious level is an unbearable threat and which in turn leads us to put them into others is what the psychoanalyst Melanie Klein (1952) called projection. She argued that in order to defend our inner self we deal with the “bad” unbearable parts of ourselves by projecting them on to others who we can then safely persecute. As members of staff working in residential child care settings we will all be aware of this process in the way that we often project all the blame for our own internal problems on to external agencies and on to other members of our team. Furthermore we do this with children. There always seems to be one child whose exclusion some or all members of staff believe would make the children’s home a better place. I would argue that if we do not acknowledge these processes then we cannot do our jobs properly. Our work will not go right if we find that the desire to criticise others and to reject others subsumes our desire to care and help. We cannot of course be perfect as carers. Indeed Winnicott (1965) suggested as parenting figures we need only be good enough. To act as what might notionally be considered “perfect” parenting figures would inevitably shelter children unduly from the risks inherent in life and leave them unable to deal with its vicissitudes. Yet in our work if we are to be good enough parenting figures it becomes more important for us to recognise our projective defences in our capacity to look for blame and fault in others. The youngsters we look after have not had good enough parenting and so not only need good enough parenting but also need parenting figures who can contain the additional fears, anxieties and the consequent projections which deeply unhappy children may carry with them.

Our resistance to group work

Wilfred Bion (1961) suggested (though be warned this is my simplification of a complex theory) that there were two kinds of organisational human groups: the work group which focuses on the task in hand and the basic assumption group which assumes that the group is always being attacked from without and within. In the latter the formation and survival of the group becomes an end in itself as both leaders and members of the group become more absorbed with their relationship to the group than with their work task. These group positions of course are not static and are related to the group’s anxieties and how they are currently contained. In a children’s home even the best of communal groups of young people and staff oscillate between being a work group and basic assumption group. This is equally true of staff groups. The issue here about “getting things right” is not that we can and should always be a work group but that we should be able to identify, acknowledge and deal with the processes which operate against the group performing its task.

What is also illuminating about Bion’s stance is that he felt groups in a sense wrestled with the same mental processes as the individual. The group like the individual can feel it is always under attack from its own uncertainties, its own insecurities and this leads it to struggle in its work. At different times all staff teams experience these anxieties and just as it is important to allow individuals the opportunity to reflect honestly on their practice so the overall group of children and care staff as well as the staff group on its own should be given opportunities to reflect upon what is happening in the group. Given the opportunity to reflect on these issues, with a containing and insightful supervisor, the group as a whole can work towards healing itself and work towards doing good enough work.

It is my view our resistance to reflecting honestly on ourselves as individuals and as staff groups is evident in our training. Very few training courses for residential child care workers include the opportunity for developing the ability to reflect deeply either as individuals or as groups. Our failure to help staff achieve this ability may in part explain why inexperienced staff who nevertheless have the potential to develop into insightful and skilled residential child care workers so often do not stay in the job for long.

The sign of civilised society: getting it right by providing unconditional care

A second thing Masud Hoghughi said rang true on that – at least for me – Damascene day was that “Caring is the sign of a civilised society” and by that he specifically said he was not talking about outcomes. A civilised society cares for its vulnerable people, full stop. I think this is something, which imbues much of what Mark Smith (2009) says and writes when he answers the question “Am I my brother’s keeper?” with such strong affirmation. I think first and foremost this is what residential child care workers do when they are at their best. They allow time for things to be as they are and don’t press the pace unnaturally. They care by consistently giving youngsters good momentary and longer term experiences. They are continually providing good food to nourish a growing sense of a healthy self within a young person. The most effective learning that children ever do is from what they discover for themselves and so it is important that they have adults around them who will expose them to good experiences. Among these experiences – the things we get right – I would include:

giving a child a warm welcome that could only be for him when he arrives at the home and always giving him that warm welcome whenever he returns from being out somewhere;

demonstrating warm respect for each child we care for in the children’s home;

showing genuine friendliness to the each of the children;

joining with children in spontaneous play both in activity and conversation;

encouraging and helping children to look well and feel well;

showing real care and nurture in our preparation and presentation of food for the children and showing our enjoyment of joining with them to eat together;

taking care to respect the culture of children and work hard to make sure they are not isolated from them;

providing children with and joining them in a variety of cultural and recreational activities;

helping children gain confidence in being a member of a group of human beings;

saying “No” to a child’s unreasonable expectations;

encouraging children and helping them with their schooling;

comforting children when they are unhappy;

helping them when things have gone wrong;

being a good adult role model;

showing the children that as colleagues we have a warmth, a care and a respect for each other.

It seems to me that by being or doing these and any number of other unsophisticated simple things with young people we are building a trusting and loving relationship with them. Of course this is easier said than done. The children and young people we are charged with caring for often have good reason to be wary of adults demanding trust and proffering love. I am not underestimating the task but if we give young people even one good experience they will carry this with them through their lives whatever the future may hold for them.

Let me finish with a story which exemplifies for me how impromptu situations can provide opportunities for good residential child care to take place. Residential child care at its best – when we “get it right” – provides good experiences, which both the youngster and the workers carry within them for life.

The Irish Sleepstakes : Jimmy’s story

One summer a number of years ago when I was a residential child care worker in a large children’s home near London my colleagues and I went on a camping holiday in Wales with a group of about 20 young people between the ages of 12 and 16 years who were then living at the home. Along with a female colleague I was delegated the task of preparing breakfasts for the group. The camp took place in mid-summer and so it got dark late and it became light very early. Following our first night under canvas the two of us responsible for the breakfast arrangements got up very early in order to give ourselves time to prepare everything properly. The children had been late settling so we were surprised when at this early hour we were joined by Jimmy, a 15 years old Irish lad. Jimmy had moved to England from his family home in a rural part of Ireland, a year before he joined us. His father had sexually abused him and he in turn had made sexual advances towards his younger siblings. This came – from his parents’ point of view – to the unwelcome notice of social services in Ireland and in order to deal with the matter his family decided to move him England where he was to stay with the family of an aunt who lived in the London area. Although Jimmy’s attendance at the local school had been irregular while he was living with his aunt, things seemed to go well for him in his new home until it was alleged that he had made sexual advances towards a girl at his school. I do not wish to make light of this but our subsequent assessment of the event was that it was less sinister than had at first been thought. Nevertheless, Jimmy’s aunt was alarmed at this development, and referred him to social services who placed him in our children’s home for assessment.

Jimmy was a lanky, fair skinned lad with dark curly hair and his face always seemed to have a rather shy smile upon it. He spoke with a strong Irish brogue which at times seemed to make understanding what he said difficult for the other kids. For this reason he was somewhat isolated from the others. He became further isolated from them when soon after arriving at the home in a bid to ingratiate himself with the other young people he shared with them the reason for his admission.

Meanwhile – as they say in the best cowboy comics – back at the camp let me remind you that Jimmie had joined my colleague and me as we began to think about how best to prepare breakfast. On the previous evening I had played badminton in the field with the other young people. Jimmy had not felt able to join them. He asked me if I would play badminton with him. We decided we could play but since everyone was still asleep it had to be called “whispering badminton”. Once we’d finished playing it on that first occasion it was still quite early and the three of us in an impromptu moment devised and played a guessing game about which of the other children and staff would get up first, second third and so on. My colleague drew out a chart with a column for our guesses and a column for recording the actual order that people got up. There seemed to be little point to the game, which we called in Jimmy’s honour, “The Irish Sleepstakes”. It was a daft game. There was no prize for winning and we participated in the spirit of play and fun of our guesses: how often they were right and how often they were wrong. Over the week we were at the camp Jimmy and I played “whispering badminton” every morning. More and more of the youngsters (and most of the staff) became involved in the fun of the “Irish Sleepstakes” and as this happened Jimmy became increasingly engaged with the main group of youngsters. He joined in their games of badminton and began to be part of smaller informal groups which formed and re-formed.

For my colleague and me it seemed like a magical time. There was a feeling of unity within the group but even more there was a sense of that integrity which can sometimes be attained when people in a group for a time are emotionally attuned. It was one of those times when we could understand why we loved being residential child care workers.

Shortly after our camping holiday Jimmy was placed on a long term basis at what was then called a CHE: a community home with education on the premises. We heard that he struggled with the more formal social climate of the CHE but he remained there for two years until he reached school leaving age.

Epilogue

Some years later I chanced to meet Jimmy while I was shopping in a nearby town. He was living in a lodging house in the town with some other Irishmen. He had a steady job as a brickie’s labourer. He said he got drunk on Friday and Saturday nights but that he had started going out with a girl and he thought he might start thinking about cutting back on the drinking.

As we were both manoeuvring towards saying farewell to each other, Jimmy asked, “Do you remember the Irish Sleepstakes?” We looked at each other for a moment and took ourselves back to the camping holiday. “Yes, I remember,” I said.